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Coma as a presenting symptom of primary HIV infection
  1. A Umgelter,
  2. W Huber,
  3. R M Schmid,
  4. W Reindl
  1. II Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, München, Germany
  1. Correspondence to:
 Dr A Umgelter
 II Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität, Ismaningerstr 22, 81664 München, Germany; andreas.umgelter{at}


Primary HIV infection (PHI) is symptomatic in 50–90% of patients. The diagnosis, however, is seldom made at first presentation. This is probably because of the multifaceted and unspecific manifestations, the omission to perform adequate diagnostic testing and the failure to assess risks for PHI. Meningoencephalitis has been described as a fairly common presenting condition in PHI, with nuchal rigidity, fatigue, photophobia and headache; therefore, PHI should be considered in the differential diagnosis of aseptic meningitis. We present the case of a man with acute coma and a presumptive diagnosis of viral encephalitis in whom serological testing showed HIV encephalitis during PHI.

  • CSF, cerebrospinal fluid
  • PHI, primary HIV infection

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  • Competing interests: None declared.

  • AU and WR drafted the article, analysed the data and performed the literature research. WH co-wrote the article. RS supplied additional data on history and follow-up of the patient and revised the article. All authors approved the final version.

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